Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany; Department of Gynecology and Obstetrics, Otto-von-Guericke University, Magdeburg, Germany.
Department of Gynecology and Obstetrics, Otto-von-Guericke University, Magdeburg, Germany.
Gynecol Oncol. 2019 Sep;154(3):475-479. doi: 10.1016/j.ygyno.2019.07.018. Epub 2019 Jul 22.
The relationship between nodal micrometastases and clinical outcome of endometrial cancer is unclear.
We performed a multicenter, retrospective registry-based study of 2392 patients with endometrial cancer with and without nodal micrometastases. The primary outcome measure was disease-free survival.
After exclusions, the final study involved 428 patients: 302 (70.6%) with node-negative endometrial cancer, who did not receive adjuvant treatment, 95 (22.2%) with nodal micrometastases who received adjuvant treatment, and 31 (7.2%) with nodal micrometastases who did not receive adjuvant treatment. The median follow-up was 84.8 months. Without adjuvant therapy the disease-free survival in the cohort of patients with micrometastases was significantly reduced as compared with disease-free survival in the node-negative cohort (p = 0.0001). With adjuvant therapy the median disease-free survival of patients with nodal micrometastases was similar with those of node-negative patients (p = 0.648). The adjusted hazard ratio for disease events among patients with micrometastases and no adjuvant therapy, as compared with node-negative patients, was 2.23 (95% confidence interval [CI] 1.26-3.95). In the cohort with micrometastases the relative risk of events was significantly decreased by adjuvant therapy (HR 0.29, 95%CI 0.13-0.65) even after adjustment for age at diagnosis, myometrial invasion, histological grade and type, and performance status.
Nodal micrometastases are associated with decreased disease-free survival of patients with endometrial cancer. Adjuvant therapy was associated with improved disease-free survival of patients with micrometastases.
淋巴结微转移与子宫内膜癌的临床结局之间的关系尚不清楚。
我们进行了一项多中心、回顾性基于注册的研究，共纳入了 2392 例有或无淋巴结微转移的子宫内膜癌患者。主要观察指标为无病生存率。
排除后，最终研究共纳入 428 例患者：302 例（70.6%）淋巴结阴性子宫内膜癌患者未接受辅助治疗，95 例（22.2%）淋巴结微转移患者接受了辅助治疗，31 例（7.2%）淋巴结微转移患者未接受辅助治疗。中位随访时间为 84.8 个月。无辅助治疗时，微转移患者的无病生存率明显低于淋巴结阴性患者（p=0.0001）。有辅助治疗时，淋巴结微转移患者的中位无病生存率与淋巴结阴性患者相似（p=0.648）。与淋巴结阴性患者相比，微转移且无辅助治疗患者的疾病事件调整后风险比为 2.23（95%置信区间 [CI] 1.26-3.95）。在微转移患者队列中，即使在调整诊断时年龄、肌层浸润、组织学分级和类型以及体能状态后，辅助治疗也显著降低了事件的相对风险（HR 0.29，95%CI 0.13-0.65）。
淋巴结微转移与子宫内膜癌患者的无病生存率降低相关。辅助治疗与淋巴结微转移患者的无病生存率改善相关。
